Assessment of the Portable COPD-6 Device for Detecting Obstructive Airway Diseases

Represas, Cristina Represas; Rial, Maribel Botana; Fernández, Virginia Leiro; Silva, Ana Isabel González; del Campo Pérez, Víctor; Fernández-Villar, Alberto

doi:10.1016/S1579-2129(10)70101-4

Archivos de Bronconeumología

ISSN: 0300-2896

Archivos de Bronconeumologia is an international journal that publishes original studies whose content is based upon results of research initiatives dealing with several aspects of respiratory medicine including epidemiology, respiratory physiology, pathophysiology of respiratory diseases, clinical management, thoracic surgery, pediatric lung diseases, respiratory critical care, respiratory allergy and translational research. Other types of articles such as editorials, reviews, and different types of letters are also published in the journal. Additionally, the journal expresses the voice of the following scientific societies: the Spanish Respiratory Society of Pneumology and Thoracic Surgery (SEPAR; https://www.separ.es/), the Latin American Thoracic Society (ALAT; https://alatorax.org/), and the Iberian American Association of Thoracic Surgery (AIACT; http://www.aiatorax.com/).

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A cross-sectional, descriptive, prospective study, that included 180 subjects. A conventional spirometry and a spirometry with the Vitalograph-COPD-6 were sequentially performed on them. The agreement was analysed [kappa index and interclass correlation coefficient (ICC)], as well as the association [Pearson correlation coefficient (r)], area under the ROC curve (AUC) of the FEV1/FEV6 in detecting obstruction, and the sensitivity, specificity, predictive values (PPV and NPV), and probability ratios (PR+ and PR–) of the different FEV1/FEV6 cut-off points in the detection of obstruction.

Results

The prevalence of obstruction was 47 %. The kappa index was 0.59 when an FEV1/FEV6 < cut-off point of < 0.7 was used. The ICC and the r between the FEV1 measured by the two instruments, FEV6 and FEV1/FEV6 measured by the Vitalograph-COPD-6 and the FVC and FEV1/FVC determined by the spirometer were all greater than 0.92. The ROC AUC was 0.97. To detect obstruction, if the cut-off point of FEV1/FEV6 (for COPD-6) was < 0.70, the sensitivity, specificity, PPV, NPV, CR+ and CR– were, 58 %, 100 %, 100 %, 73 %, ∞ and 0.42, respectively. For a cut-off point of < 0.8, they were 96 %, 76 %, 78 %, 96 %, 3.8 and 0.05, respectively.

Conclusions

The portable Vitalograph-COPD-6 device is precise for the detection of airway obstruction. The best sensitivity/specificity of FEV1/FEV6 was obtained with cut-off points greater than 0.7.

Keywords:

FEV6

Spirometry

Screening

Chronic obstructive pulmonary disease

Resumen

Objetivos

Evaluar la concordancia y la relación del FEV1, FEV6 y FEV1/FEV6 medidos con el dispositivo portátil Vitalograph-COPD-6 y del FEV1, FVC y FEV1/FVC mediante espirometría convencional y analizar la validez de este dispositivo para detectar obstrucción.

Metodología

Estudio prospectivo, descriptivo, transversal. Se incluyeron 180 sujetos a los que se les realizó secuencialmente una espirometría convencional y una con el Vitalograph-COPD-6. Se analizó la concordancia (índice kappa y coeficiente de correlación intraclase [CCI]), relación (coeficiente de correlación de Pear son [r]), área bajo la curva (ABC) ROC del FEV1/FEV6 en la detección de obstrucción y se calcularon la sensibilidad, especificidad, valores predictivos (VPP y VPN) y cocientes de probabilidad (CP+ y CP–) de distintos puntos de corte del FEV1/FEV6 en la detección de obstrucción.

Resultados

La prevalencia de obstrucción fue del 47 %. Utilizando un punto de corte del FEV1/FEV6 < 0,7 el índice kappa fue de 0,59. El CCI y el r entre el FEV1 medido por los 2 aparatos, FEV6 y FEV1/FEV6 medido por el Vitalograph-COPD-6 y la FVC y FEV1/FVC determinados por el espirómetro fueron todos superiores a 0,92. El ABC ROC fue de 0,97. Para detectar obstrucción, si el punto de corte de FEV1/FEV6 (por COPD-6) es < 0,70, la sensibilidad, especificidad, VPP, VPN, CP + y CP– fueron 58 %, 100 %, 100 %, 73 %, ∞ y 0,42, respectivamente. Para un punto de corte < 0,80 fueron 96 %, 76 %, 78 %, 96 %, 3,8 y 0,05, respectivamente.

Conclusiones

El medidor portátil Vitalograph-COPD-6 es preciso para la detección de obstrucción de la vía aérea. La mejor relación sensibilidad/especificidad del cociente FEV1/FEV6 se obtuvo con puntos de corte superiores a 0,7.

Palabras clave:

FEV6

Espirometría

Cribado

Enfermedad pulmonar obstructiva crónica

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